View report page

of the Borough Council. The School Health Services for some 10,000
children between the ages of 5 and 16 or over in primary, secondary,
and special schools were administered by the Hornsey Education
Committee.
These, together with Clinics, Centres, Day Nurseries, and all staffs
and equipment were transferred to Middlesex County Council as the
Health Authority. The Maternity & Child Welfare Committee of the
Borough Council was sunk without trace on July 5th, 1948. The transferred
personal health services are now administered by Area No. 3
(Tottenham and Hornsey) Health Sub-Committee of the County Health
Committee. As an illustration of how unnatural all these vast changes
are, may be mentioned the fact that the Health Centre at the Hornsey
Town Hall comprising a School Clinic and a Maternity & Child Welfare
Centre, within 50 yards of the Medical Officer of Health's room in the
Town Hall, will shortly be administered from No. 3 Area Headquarters
situated in a building 3 miles away which used to be the Tottenham
Grammar School!
3. Environmental Health Services
These changes put the Borough Council firmly where it was in the
nineteenth century—that is, in charge of the sanitary circumstances of
its area. As a Sanitary Authority it is responsible for House Repairs,
Nuisances, Food Inspection, Atmospheric Pollution, Destruction of Rats
and Mice, Control of Infectious Diseases—very important functions which
are the day-to-day duties of the Sanitary Inspectors.
DICHOTOMY OF MEDICAL OFFICER OF HEALTH
The trichotomy of the health services has led to dichotomy of the
Medical Officer of Health. I have been split into two portions—the
smaller of which, representing 40% of me, remains Medical Officer of
Health of the Borough of Hornsey; the larger and, presumably, the more
important portion 60%, becomes "Area Medical Officer" for the
Hornsey part of Area No. 3 (Tottenham and Hornsey) of the County of
Middlesex. In this capacity I am virtually an Assistant M.O.H. to the
Middlesex County Medical Officer of Health, responsible to him for the
carrying on, in this part of the area, of the personal health services which
the Borough Council has gradually built up in the last half century and
lost suddenly by a stroke of the legislative pen on July 5th, 1948.
This is a position which neither the Borough Council nor its Medical
Officer of Health sought or did anything to bring about. The change
was imposed on us by the National Health Service Act, 1946. Widespread
dissatisfaction and deep resentment are manifest in the current
medical journals amongst many medical men and women at the adverse
influence of the Act on their status and prospects—but I know of no
reduction of status so drastic as that which has befallen Medical Officers
of Health of Municipal Boroughs.
The annals of fiction and crime contain many interesting references
to that strange psychosis "split mind" or "split personality" or, as
psychiatry calls it, "schizo-phrenia." In the various closely related and
sometimes overlapping duties for which I am responsible in my dual
6